This document outlines the strategies used in Dialectical Behavior Therapy (DBT) for problem solving. It describes a two-part process: 1) Problem Analysis (A) which involves understanding the problem by defining behaviors, chain analyzing triggers, formulating hypotheses, and providing insight. 2) Solution Analysis (B) which involves identifying goals, generating alternative solutions, evaluating options, choosing a solution, and troubleshooting potential issues with implementation. The overall goal is to help clients effectively address problems and challenging behaviors.

1. CHANGE strategies:
PROBLEM SOLVING A (analyse problem) & B
(choose solution-solution analysis)
• A UNDERSTAND AND ACCEPT the problem
at hand (behaviour analysis techniques,
insight techniques)
• B generate, evaluate and implement
ALTERNATIVE SOLUTIONS (solution
analysis techniques & get commitment to act)

2. Before and during PROBLEM SOLVING:
orient the client
• orient client to DBT and to HER ROLE in
therapy
• Use list of TARGET BEHAVIOURS
• EXPLAIN problem-solving strategies
• REHEARSE with client exactly what she is to do
in trying to respond to the problem

3. PROBLEM SOLVING A (analyse problem)
•1 Define the behaviour: choose
focus, formulate, describe
•2 Chain Analyse target
behaviours

4. PROBLEM SOLVING A (analyse problem)
• 3 Formulate the problem: in terms of client’s
or therapist’s behaviour
• 4 Provide insight highlight, observe and
describe patterns, comment on implications of
behaviour, assess difficulties in
accepting/rejecting hypotheses
• 5 Be didactic provide information, reading,
family sessions

5. PROBLEM SOLVING A (analyse problem)
• 1 Define the behaviour:
•
• choose focus: Use the target hierarchy
• Describe: the problem specifically
• Validate: the client’s distress

6. Problem-solving
• 2 CHAIN ANALYSE TARGET BEHAVIOUR
• Choose specific instance
• Links: where to start? Filling in the links
• Where to stop?
• Analyse in-session behaviours
• Watch out for therapist and client avoidance!!

8. PROBLEM SOLVING A (analyse
problem)
• 3 Formulate what?
• Target behaviours and their precursors
• Observable events
• Current events

9. PROBLEM SOLVING A (analyse problem)
3 Formulate how?
1 Generate hypotheses about factors
controlling behaviour ABC
• Use theory to guide analysis
• Look for unbearable emotion as antecedent
• Look for negative reinforcement (escape)

10. PROBLEM SOLVING A (analyse problem)
• 4 provide insight: how?
• Highlight: patterns of behaviour
• Observe and describe: recurrent patterns
• Comment on implications
• assess difficulties in accepting/rejecting
hypotheses

11. PROBLEM SOLVING A (analyse problem)
• 4 provide insight: how?
• Be non-judgmental
• observe the effects of formulation and
react
• surround insight with validation

12. PROBLEM SOLVING A (analyse problem)
• 4 provide insight: how?
• Base explanations on bio-social theory, rules
governing client’s behaviour
• use DBT assumptions (client is trying her best
etc)
• Use non-pejorative language

13. PROBLEM SOLVING A (analyse problem)
• 5 be didactic
• Give reading, websites,videos, DVDs
• Give info to family/friends/carers

14. PROBLEM SOLVING B (solution analysis)
•
• 1 INDENTIFY WANTS, NEEDS and GOALS
(life-goals)
• 2 GENERATE SOLUTIONS
• 3 EVALUATE solutions generated
• 4 choose a solution
• 5 TROUBLESHOOT review ways in which
attempts to solve problem can go wrong.

15. PROBLEM SOLVING B (solution analysis)
• 2 GENERATE SOLUTIONS
• Brainstorm every possibility
• Suspend judgment
• Be irreverent if appropriate

16. PROBLEM SOLVING B (solution analysis)
• 3 EVALUATE solutions generated
• Pros & cons
• Give points
• Reject immoral/impractical
• Do not accept ‘I can’t’

17. PROBLEM SOLVING B (solution analysis)
• 4 choose a solution
• Select most effective remaining option
• Use mindfulness & commitment strategies to
address ‘I can’t’ and ‘I won’t’
• Obtain promise to implement solution

18. PROBLEM SOLVING B (solution analysis)
• TROUBLESHOOT potential pitfalls/obstacles
• Anticipate what might go wrong
• Make plans to cover these eventualities
• Obtain commitment to implement these plans
• Reinforce all desired behaviour in solution
analysis session

19. Consult group
• Use problem analysis and solution analysis in
consult group meetings